Psychosocial Interventions in the Treatment of Severe Adolescent Obesity: The SHINE Program

Psychosocial interventions (PSIs) are characterized by three phases: (1) an initial in-depth assessment, (2) an intensive multifaceted intervention to stem a condition, and (3) an extensive maintenance program. PSIs are often used for treatment of mental health conditions; however, applicability in the treatment of adolescent obesity is unknown. This article sought to evaluate the service-level outcomes of a PSI for young people (aged 10-17) with severe obesity.

A retrospective evaluation of participants attending the Self Help, Independence, Nutrition and Exercise program between 2011 and 2016 (n = 435; age: 13.1 ± 2.1 years, male: 51%, white: 87.4%, body mass index [BMI]: 33.5 ± 7.5 kg/m², standardized BMI [BMI SDS]: 3.1 ± .5 units). Anthropometric measurements (BMI and waist circumference) were collected at baseline, 3, 6, 9, and 12 months. Psychosocial measures (anxiety, depression, and self-esteem) were collected at baseline and 3 months. Participant retention was also assessed.

After 3 months, 95% of participants remained with a mean BMI SDS reduction of .19 units (95% confidence interval: .17, .21). Anxiety, depression, and self-esteem improved by 50%, 54%, and 38%, respectively. BMI SDS reductions of .29, .35, and .41 units were found at 6, 9, and 12 months. Fifty-four percent of participants chose to attend the final intervention phase. A higher baseline BMI SDS and a greater reduction in BMI SDS predicted final intervention phase attendance.

The Self Help, Independence, Nutrition and Exercise PSI demonstrated positive mean reductions in all measurements across all time points. In contrast to other community-based weight management services, these results suggest the utility of, and further exploration of, PSIs in the treatment of severe adolescent obesity.